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Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide

from Liver Transplantation (login required)

In living donor liver transplantation (LDLT), insufficient graft volume could result in small-for-size syndrome in recipients, whereas major liver donation predisposes the donor to a high risk of posthepatectomy liver failure. Dual graft LDLT is therefore introduced to obtain combined graft sufficiency. To date, 367 patients have been reported worldwide. We reviewed all the relevant literature, with a special focus on 43 case reports containing enough data to extract and analyze. A simple decision-making algorithm was developed. Dual graft LDLT is indicated when a single donation is unacceptable due to graft-to-recipient size mismatch; the future liver remnant is insufficient in the single donor after major resection; or there is a significant underlying disorder or anatomical variation within the donor liver. more

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